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“Our SYNERGIC Trial will support preventative treatment for dementia by showing how cognition can be improved through combining exercise with cognitive training. This will help to lay out future clinical guidelines for physicians whose patients are at risk of developing dementia. Our findings not only have the potential to improve the quality of life of older Canadians, but with each 1-year delay of progression to dementia, the Canadian health care system can save billions of dollars.” Dr. Manuel Montero Odasso

A research participant in the SYNERGIC Trial

Evidence from clinical trials and studies shows a strong link between cognitive decline and mobility impairments. So much so, in fact, that older adults with cognitive decline are two-times more likely to take the kind of debilitating falls that require institutional care.

That is because important aspects of cognition – like attention and memory – share the same brain circuits that control walking and navigation. Yet, despite the clear connection, declines in mobility and cognition remain separately assessed by physicians, as there are no specific recommendations available to guide them in making combined assessments.

In an effort to address this gap, Drs. Manuel Montero-Odasso and Louis Bherer lead a team within the Canadian Consortium on Neurodegeneration in Aging who are working to develop clinical recommendations that will help physicians assess mild cognitive impairment (MCI) and slow its progression. As an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia, MCI involves problems with memory, language, thinking, and judgment. According to Montero-Odasso, “up to 75% of people with MCI may evolve to dementia symptoms, particularly Alzheimer’s Disease.”

Consensus Meeting held in Montreal, QC with all the Mobility, Exercise, and Cognition Team members and the international advisory board, which includes Drs. Olivier Beauchet, Caterina Rosano, Jeff Hausdorff, Joe Verghese, and Stephanie Studenski.

Now for the good news: Research has demonstrated that exercise positively impacts cognition in people with MCI – reducing the number and severity of falls – and cognitive brain training activities increase mobility and one’s ability to exercise. By contrast, vitamin D deficiency is linked to cognitive decline, Montero-Odasso notes.

It stands to reason that combining exercise, cognitive training, and increased vitamin D intake would create better results than any one of these interventions alone. And that’s just what Montero-Odasso and Bherer are doing with a team of researchers across Canada. Their SYNERGICTrial targets cognitive decline at its earliest stage – in individuals with MCI – where interventions are more likely to have an impact and can be monitored.

Team Leader Dr. Montero-Odasso with co-leader Dr. Louis Bherer and Drs. Chertkow and Camicioli attending the Gait and Cognition Consensus Meeting held in Montreal, QC.

Says Montero-Odasso: “I am privileged to co-lead a team with Dr. Bherer, composed of outstanding Canadian researchers in cognition, mobility, exercise, and cognitive intervention. Site leaders for our trial, Dr. Liu-Ambrose in Vancouver, Drs. Middleton and Almeida in Waterloo, and our national research coordinator, Alanna Black, have been instrumental in implementing our trial. We also have excellent scientists helping us to optimize the intervention protocol, including Drs. Richard Camicioli, Karen Li, Sarah Fraser, Mark Speechley, and Julian Doyon, among others.”

SYNERGIC

SYNERGIC is the first study of its kind to test the combined effects of the triple intervention – exercise, cognitive training, and increased vitamin D intake – in delaying the onset of dementia. Rolled out in the fall (2016), the clinical trial is now taking place in London, Vancouver, Montreal, and Waterloo, involving 200 participants over 60 years old with MCI. Over the course of 6 months, the study measures the effects of regimented exercise and cognitive training on iPads (3x per week), in conjunction with vitamin D intake. The exercise and cognitive training is customized to participants’ abilities and progresses in complexity based on their advances.

In Montero-Odasso’s words, “we’re hoping that when participants return to our labs 6 months after the trial ends we’ll see an improvement in their cognitive scoring for memory, attention, and executive functioning. Our results will also help physicians to provide tailored information on treatments to patients with MCI that may help to delay the onset of dementia.”

To learn more about SYNERGIC and the latest findings coming out of the consortium, visit the CCNA’s news features where regular updates are provided.